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BILL GATES Co-Chair Bill & Melinda Gates Foundation RAY BILL GATES Co-chair Bill & Melinda Gates Foundation RAY CHAMBERS United Nations Secretary-General's Special Envoy for Financing the Health Millennium Development Goals and for Malaria Photo by Esther Havens / Malaria No More From Aspiration to Action | 4 Table of Foreword 5 Contents Key Messages 9 Overview 13 Why do we need to end malaria? 15 What will it take to end malaria? 17 I. New Strategies 31 II. New Tools 39 III. New Financing 43 Conclusion 51 Appendices 53 5 | From Aspiration to Action Foreword In the year 2000, the world committed to “halt and reverse” the tide of malaria as a key element of the Millennium Development Goals. Fifteen years later, we have achieved that goal and more. An estimated 6.2 million lives have been saved from malaria since the year 2000, and the rate of deaths from malaria has been reduced by an astonishing 58% globally. Based on this success, we have an opportunity to do 2030. Work to achieve that goal is under way and an economic progress and help to ensure that all what was once thought impossible: to end this disease Asia Pacific Malaria Elimination Roadmap for action children have the opportunity to lead the healthy and for everyone, everywhere on the planet, forever. has been drafted for consideration at the November productive lives to which they are entitled. 2015 East Asia Summit. As co-chair of UN Secretary General Ban Ki-Moon’s Success will demand the dedication of all stakeholders, High Level Panel of Eminent Persons on the Post- In line with this goal, I welcome the bold vision and it will require that afected countries strengthen 2015 Development Agenda I applaud the initiative for global malaria eradication contained in From their health systems, enhance their disease behind the call for action and the vision that gives Aspiration to Action: What will it Take to End Malaria? As surveillance capabilities, and their capacity to treat and us of our potential as a global family to eliminate we all know, a malaria-free world can only be achieved care for those afected—in short we need to prevent malaria. through careful planning, continuous innovation, hard new malaria, quickly detect infection, and respond work, and active leadership pointing the way, calling rapidly and appropriately. Ultimately leaders of malaria-afected countries for action and providing necessary resources. The are accountable for keeping their citizens safe from global community must move forward together fully The most precious resource of any nation is its malaria and accelerating the elimination of a disease committed to working for achievement of national children, and leaders in all countries are focused on that claims the lives of more than 500,000 people and regional plans well supported by the new tools, the goal of creating a future where no child sufers each year. I am gratified that in my own region with strategies, and the financing required to accelerate or dies unnecessarily. That means we must eliminate the support of Asia Pacific Leaders Malaria Alliance elimination of malaria. malaria. I thank the authors of “From Aspiration (APLMA), we have set ambitious elimination goals. to Action” for showing us so clearly that this is In November 2014, at the East Asia Summit, 18 For all our progress, more than half of the world’s something we can and must do. countries gathered at the East Asia Summit joined children still live at risk of malaria. Eliminating in pledging to eliminate the disease in our region by malaria will remove a key barrier to social and Jakarta, August 2015 Dr. Susilo Bambang Yudhoyono President of Indonesia (2004-2014) Co-Chair of the Secretary General’s High Level Panel of Eminent Persons on the Post-2015 Development Agenda From Aspiration to Action | 8 Foreword The global community has proven that we can overcome the most formidable of challenges through innovative partnerships and ambitious-yet-achievable targets. An outstanding example is the unprecedented success we have achieved against the scourge of malaria. Since the adoption of the Millennium Development Goals in 2000, we have saved more than 6 million lives globally and reduced malaria deaths in children under five by nearly 70% in Africa. We now stand positioned to accomplish what has evaded prior generations—ending malaria once and for all. From Aspiration to Action: What Will It Take to End impede on the prosperity of our communities, taking Malaria? recognizes this unique opportunity and lays huge human and economic tolls across the continent. out the key elements to achieve a world free of malaria: country and regional strategies, maintaining political In January 2015, Africa’s Heads of State and leadership, strong multi-sectorial partnerships, Government convened at the African Union in Addis new investments and financing strategies, and the Ababa, Ethiopia and pledged to work together to development of innovative prevention and diagnostic achieve a malaria-free Africa within a generation. tools. All are key in driving this necessary work Through the African Leaders Malaria Alliance forward. We embrace the opportunity to contribute (ALMA), a coalition of 49 African heads of state, the to this efort, and we commit to seeing this bold aim continent’s malaria-afected countries have adopted of global eradication achieved. a rigorous elimination scorecard that will allow them to track their progress toward achieving efective In the past 15 years, Sub-Saharan Africa has made intervention coverage and significant reductions in historic progress in turning the tide against malaria. parasite burden. This scorecard is already helping Incidence of the disease has declined by more than eight nations in southern Africa scale up their eforts one-third, and deaths have fallen by 58% among to achieve malaria elimination by 2020. all age groups. Thanks to strong collaboration between African governments and the international We must seek the end of malaria—there is no other donors, the percentage of Africans who have access way forward. The time is now to make the vision of to afordable treatment and diagnosis has grown From Aspiration to Action become reality. dramatically. Yet, the burden of malaria continues to His Excellency Jakaya Mrisho Kikwete President of the United Republic of Tanzania Founding Chair of the African Leaders Malaria Alliance AWA Champion for Malaria Prevention and Control 9 | From Aspiration to Action From Aspiration to Action | 10 ERADICATION WILL PRODUCE ENORMOUS HEALTH Key Messages AND ECONOMIC BENEFITS. Leading economists have identified the fight THE WORLD HAS MADE UNPRECEDENTED PROGRESS against malaria as one of the “best buys” in global AGAINST MALARIA IN THE PAST 15 YEARS. development, estimating that a 50-percent reduction in Since 2000, global malaria deaths have fallen 58 global malaria incidence could produce $36 in percent, and half of the world’s nations are now economic benefits for every $1 invested.4 A new malaria-free.1 Gains against malaria account for 20 analysis also indicates that malaria eradication could percent of the total progress that the world has made deliver more than $2 trillion (U.S.) in economic benefits in reducing preventable child and maternal mortality and save an estimated 11 million lives. under the Millennium Development Goals (MDGs).2 ERADICATION IN THE 21ST CENTURY WILL DIFFER THE LEADERS OF THE WORLD’S MALARIA- DRAMATICALLY FROM PAST EFFORTS. AFFECTED COUNTRIES HAVE MADE A STRONG Malaria eradication will not rely on the 20th-century POLITICAL COMMITMENT TO MALARIA ELIMINATION. model of a large-scale global campaign funded and Progress against malaria has convinced Asian and organized by foreign donors and focused on a single African leaders to commit their regions to malaria intervention. Its success today will depend on the degree elimination within a generation.3 The World Health to which countries integrate malaria surveillance, Organization’s (WHO) Global Technical Strategy transmission interruption, and treatment programs for Malaria (GTS) and the Roll Back Malaria (RBM) into their national health systems. Eradication in Partnership’s Action and Investment to defeat Malaria the 21st century will adapt to emerging challenges (AIM) have embraced the goal of a “world free of by using data to plan interventions and R&D to stay malaria.” ahead of drug and insecticide resistance. It will also use operational research to identify the most efcient and efective approaches for deploying new tools and ERADICATION IS THE ONLY SUSTAINABLE SOLUTION strategies as they become available. TO MALARIA. The alternative to eradication—controlling the disease forever without eliminating it—is operationally and IN CONTRAST TO OTHER ERADICATION EFFORTS, politically untenable. It would require indefinite ENDING MALARIA WILL NOT BE A HIGH-RISK, ALL- investment in malaria control and the development OR-NOTHING PROPOSITION. and delivery of an endless succession of treatment and More than 100 United Nations member states have prevention technologies to stay ahead of resistance in successfully eliminated malaria, and history has shown both parasites and mosquitoes. It will be impossible to that elimination “sticks” once it has been achieved. This maintain strong political commitment unless we can means that regions that have eliminated the disease To achieve the aspiration define a clear end point—and history has shown that will not need to maintain costly and intensive malaria of a malaria-free world, we unless countries reduce their case burdens to zero, we surveillance eforts and can use more general infectious will see resurgence on a massive scale. disease surveillance to avoid resurgence. It also means must start taking action now. that countries and regions will be able to set their own schedules for elimination once they are confident that 1 United Nations, The Millennium Development Goals Report 2015 (New York: UN, 2015). the necessary tools, strategies, and financing are in 2 World Health Organization, World Malaria Report 2014 (Geneva: WHO, 2014).
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